Individual
MRS. DENISE ROSE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
27483 DEQUINDRE RD, SUITE 314, MADISON HEIGHTS, MI 48071-3491
(248) 547-6600
(248) 547-5696
Mailing address
27483 DEQUINDRE RD, SUITE 314, MADISON HEIGHTS, MI 48071-3491
(248) 547-6600
(248) 547-5696
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004747
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790704062
—
MI
01
—
700H217350
BLUE SHIELD
MI
Enumeration date
07/18/2006
Last updated
07/09/2014
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